ASHWIN RAMANANDA PRABHU BDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001533

License Status

NOT RENEWED

Business

First Name

ASHWIN

Middle

RAMANANDA

Last Name

PRABHU

Suffix

BDS

Business Name

ASHWIN RAMANANDA PRABHU BDS

Original Issue Date

12/28/2004

Effective Date

09/11/2006

Expiration Date

09/15/2006

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

11/03/2006